tetano
Editor, Senior Moderator
Am J Cardiol
. 2026 Apr 6:S0002-9149(26)00177-3.
doi: 10.1016/j.amjcard.2026.03.040. Online ahead of print.
Mortality and Morbidity Benefit After Influenza Vaccination in High Cardiovascular Risk Population: a Systematic Review and Meta-analysis
Kaveh Hosseini[SUP] 1 [/SUP], Parham Dastjerdi[SUP] 2 [/SUP], Reza Yahyavi Sahzabi[SUP] 3 [/SUP], Arghavan Alipoor[SUP] 3 [/SUP], Mahyar Masanabadi[SUP] 3 [/SUP], Parastesh Rezvanian[SUP] 3 [/SUP], Yasaman Daryabari[SUP] 3 [/SUP], Maede Mehdizadeh[SUP] 3 [/SUP], Sanaz Soleimani[SUP] 3 [/SUP], Daniel Modin[SUP] 4 [/SUP], Kristoffer Grundtvig Skaarup[SUP] 4 [/SUP], Tor Biering-Sørensen[SUP] 5 [/SUP]
Affiliations
Influenza infection increases cardiovascular risk in patients with ischemic heart disease (IHD) or heart failure (HF). This updated meta-analysis evaluated the cardiovascular benefits of influenza vaccination in these populations.Two complementary approaches were used: an individual patient data (IPD) meta-analysis for the primary outcome (reconstructed from published Kaplan-Meier curves) and conventional study-level random-effects meta-analyses for all outcomes. Cox models were used to estimate pooled hazard ratios (HRs). Heterogeneity was explored using subgroup, sensitivity, and meta-regression analyses, and study quality was assessed with RoB 2 and ROBINS-I.Twenty-three studies (7 RCTs, 16 observational; n = 1,137,377) met inclusion criteria. Influenza vaccination significantly reduced all-cause mortality (HR = 0.72; 95% CI: 0.63-0.82) and cardiovascular mortality (HR = 0.77; 95% CI: 0.67-0.89). Vaccinated patients also had a lower risk of MI (HR = 0.81; 95% CI: 0.78-0.83), whereas effects on stroke (HR = 0.88; 95% CI: 0.68-1.14) and MACE (HR = 0.81; 95% CI: 0.57-1.15) were not significant. Reconstructed individual data (n = 22,443) demonstrated a 38% mortality reduction (HR = 0.62; 95% CI: 0.57-0.67), with the greatest benefit in the first four months post-vaccination. Effects were consistent across age, disease type, study design, and follow-up duration. In conclusion, Influenza vaccination markedly lowers mortality and provides cardiovascular protection in patients with IHD or HF, supporting annual vaccination as an effective secondary prevention strategy.
Keywords: Heart failure; Influenza vaccine; Ischemic heart disease; Meta-analysis.
. 2026 Apr 6:S0002-9149(26)00177-3.
doi: 10.1016/j.amjcard.2026.03.040. Online ahead of print.
Mortality and Morbidity Benefit After Influenza Vaccination in High Cardiovascular Risk Population: a Systematic Review and Meta-analysis
Kaveh Hosseini[SUP] 1 [/SUP], Parham Dastjerdi[SUP] 2 [/SUP], Reza Yahyavi Sahzabi[SUP] 3 [/SUP], Arghavan Alipoor[SUP] 3 [/SUP], Mahyar Masanabadi[SUP] 3 [/SUP], Parastesh Rezvanian[SUP] 3 [/SUP], Yasaman Daryabari[SUP] 3 [/SUP], Maede Mehdizadeh[SUP] 3 [/SUP], Sanaz Soleimani[SUP] 3 [/SUP], Daniel Modin[SUP] 4 [/SUP], Kristoffer Grundtvig Skaarup[SUP] 4 [/SUP], Tor Biering-Sørensen[SUP] 5 [/SUP]
Affiliations
- PMID: 41951138
- DOI: 10.1016/j.amjcard.2026.03.040
Influenza infection increases cardiovascular risk in patients with ischemic heart disease (IHD) or heart failure (HF). This updated meta-analysis evaluated the cardiovascular benefits of influenza vaccination in these populations.Two complementary approaches were used: an individual patient data (IPD) meta-analysis for the primary outcome (reconstructed from published Kaplan-Meier curves) and conventional study-level random-effects meta-analyses for all outcomes. Cox models were used to estimate pooled hazard ratios (HRs). Heterogeneity was explored using subgroup, sensitivity, and meta-regression analyses, and study quality was assessed with RoB 2 and ROBINS-I.Twenty-three studies (7 RCTs, 16 observational; n = 1,137,377) met inclusion criteria. Influenza vaccination significantly reduced all-cause mortality (HR = 0.72; 95% CI: 0.63-0.82) and cardiovascular mortality (HR = 0.77; 95% CI: 0.67-0.89). Vaccinated patients also had a lower risk of MI (HR = 0.81; 95% CI: 0.78-0.83), whereas effects on stroke (HR = 0.88; 95% CI: 0.68-1.14) and MACE (HR = 0.81; 95% CI: 0.57-1.15) were not significant. Reconstructed individual data (n = 22,443) demonstrated a 38% mortality reduction (HR = 0.62; 95% CI: 0.57-0.67), with the greatest benefit in the first four months post-vaccination. Effects were consistent across age, disease type, study design, and follow-up duration. In conclusion, Influenza vaccination markedly lowers mortality and provides cardiovascular protection in patients with IHD or HF, supporting annual vaccination as an effective secondary prevention strategy.
Keywords: Heart failure; Influenza vaccine; Ischemic heart disease; Meta-analysis.